Lichen Planus (LP) is a chronic, inflammatory--and, so far, incurable--disease of unknown etiology, affecting skin and mucosa of approximately 2% of the population. Because several clinical studies have indicated that LP patients have an increased risk for developing oral cancer, the currently recommended management includes control of lesions with corticosteroids or other immunosuppressants, plus follow-up checks of the patient 2-4 times annually. This involves considerable stress and cost for both the patients and their health providers. Furthermore, oral LP lesions sometimes resemble oral pre-malignant lesions, and currently only a biopsy can conclusively confirm the difference. Therefore, LP patients often face a lifetime of repeated oral biopsies in the effort to catch any malignancy in its beginning stages. The long-term goal of this proposed research is to develop a non-invasive screening test for early detection of malignant changes in LP patients. Whether some of the recently identified salivary biomarkers for oral cancer may prove useful for screening LP patients for this purpose has never been investigated, but the approach seems promising. Therefore, the objective of this pilot study is to obtain initial data on whether any known OSCC salivary biomarkers can serve as biomarkers for detection of any malignant changes in LP patients. Our specific aims are to collect salivary samples from groups of LP patients, oral cancer patients and patients who have LP and have developed oral cancer. Each saliva sample will be measured for the quantity of each of 17 currently-known oral cancer biomarkers, and comparisons between groups will be made. At completion of this pilot study, we will have obtained the initial data required for further, larger-scale studies on the efficacy and reliability of salivary biomarkers as possible indicators of malignant changes in oral LP patients. The project is significant because the outcomes will 1) benefit LP patients worldwide 2) enable clinicians to more often detect oral cancer in its early stages;3) expand understanding of the relationships between cancer biology and inflammatory disorders;4) provide reference for early detection of malignancy in patients who have other inflammatory diseases at higher risk for developing cancers (e.g., detecting gastro-intestinal cancers in patients with chronic gastritis or inflammatory bowel diseases). PUBLIC HEALTH RELEVANCE: Lichen Planus (LP), an incurable, chronic inflammatory disease, is the most common oral mucosal disease seen in dentistry, and evidence suggests that LP patients are at higher risk for oral cancer. Several salivary biomarkers for oral cancer have been identified in recent years. This proposed study is for gathering preliminary data regarding the feasibility of using those biomarkers for early detection of oral cancer in this high risk group.